2014

Effect of left ventricular ejection fraction on remote prognosis of patients after a cardiac catastrophe. Analysis of 5-year monitoring performed as a part of the population-based program “Registry of acute myocardial infarction”

Background. According to numerous reports, LV EF is preserved in a considerable proportion of patients with HF symptoms. The Framingham study has demonstrated better survival of patients with preserved LV systolic function compared to patients with reduced EF. However controversial results were obtained in some studies, which demonstrated comparable survival of such patients. Aim. To evaluate the effect of LV EF on prognosis for patients of able-bodied age who have had an acute MI. Materials and methods. The study included 365 patients who had had a MI and had been registered in the “Registry of Acute MI” database. Based on LV EF, the patients were divided into three groups: group 1 (n=23), patients with EF ≤35%; group 2 (n=84), “grey zone” patients with 36 ≤EF ≤49%); group 3 (n=258), patients with EF ≥50%. The highest mortality rate of patients with low EF was observed at 3 years of follow-up; later, at 5 years of MI, this index tended to decrease. In patients with preserved EF, the death rate clearly tended to increase throughout the follow-up period. For the 5-year follow-up period, 30.4 % of patients died in the group with reduced EF; 19 % of patients died in the «grey zone» group; and 16.6 % of patients died in the group with preserved EF. Statistical analysis showed that differences between groups in the death rate were not significant. Conclusion. The 5-year mortality rate of patients who have had an acute MI did not depend on LV EF. Low EF determined the death rate in the first three years after MI. Subsequently, the effect of this index evened out, which justified a need for more aggressive therapeutic strategy in patients with preserved EF as such patients have traditionally received less attention than patients with systolic dysfunction.

Garganeeva A.A., Borel K.N., Okrugin S.A., Kuzheleva E.A. Effect of left ventricular ejection fraction on remote prognosis of patients after a cardiac catastrophe. Analysis of 5-year monitoring performed as a part of the population-based program “Registry of acute myocardial infarction”. Russian Heart Failure Journal. 2014;85 (4):218–223